HomeMy WebLinkAboutVOID - RESTAMP.1
OMCE USE ONLY:
DATE FILED: )IT
REVISION FEE: 00
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RECEUT#
PLANNING & DEVELOPMENT SERVICES
BUILDING & CODE REGULATION DIVISION
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DETAILED DESCRIPTION OF PROJECT
CONTRACTOR ]INFORMATION:
STATE of FL REGJCERT.
BUSINESS NAME: ffip
QUALIFIERS NANE7:jY6
CITY: 31U
PHONE (DA
OVMR/BUILDER
NAME:
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-ST.LUCIECOCERT.#: lq5u_S
ZIP:
TAR: (-41lWXLP-0LlUl
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STATE: V-L ZIP:
FAX:
ARCHITECT/ENGINEER INFORMATION:
ADDRESS:
CITY:
PHONE (DAYTMffi):
SLCCC 9123109
Revised 06130117
STATE:
ZIP:
RECEIVED
OCT 18 2018
Permitting Department
St. Lucie County, FL
OFFICE USE ONLY:
DATE FILED: /0- )'3- ) 11
REVISION FEE: c-0
PERAM #
RECEEPT #
PLANNING & DEVELOPMENT SERVICES
Vol BUILDING & CODE REGULATION DIVISION
2300 VIRGINIA AVENUE
FORT PIERCE, FL 34982-561% 1
1) (772)462-1553
APPLICATION FOR BUILDING PE
PROJECT INFORMATION
LOCATION/SITE
DETAILED DESCRIPTION OF PROJECT
CONTRACTOR INFORMATION:
STATE of FL REG./CERT.
BUSINESSNAME: --I&
QUALIFIERS NAME: J)j
CITY: 3T[kal-r
PHONE (DAYTRAE):
OWNER/BUILDER INFORMATION:
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NAME: VO " �j
ADDRESS: I kM S
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CITY: ASP -A A
PHONE (DAYTIME:
ARCMTECT/ENGINEER INFORMATION:
NAME:
ADDRESS:
CITY:
PHONE (DAYTIME):
SLCCC 9123109
Revised 06130117
STATE:
ST. LUCIE CO CERT. #: MA
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ZIP:
RECEIVED
OCT 18 2018
Permitting Department
St. Lucie County, FL